Currently we change our needleless connectors q 7 days and prn. INS Standard 35 C states the optimal interval for changing injection or access caps on central, peripherally inserted central, and midline catheters is unknown; however, it is recommended that they be changed at least every 7 days. It then references Standard 29 which states add-on devices should be changed with each administration set replacement.
How confusing is this. So if following the standard, our intermittent tubing gets changed q 24 hours, we would need to change the connector along with it. I know this is not doable financially.
What is your practice and is your practice based upon another standard? Our CLABSI rate is below the benchmark but we have not been able to sustain zero for more than a 5 month stretch. The connector time of use is somthing I'm exploring now.
You are correct about the confusion in the current INS standards. We are working hard to correct all of that confusion with the new edition that will be out Jan 2011. I would refer you to the CDC guidelines from 2002. That document states that needleless connectors should be changed at the same interval as IV administration sets. Since CDC did not recognize a difference between continuous and intermittent sets in 2002, I would say that the change interval for needleless connectors should be at 72 or 96 hours based on your policy for continuous sets. Another element of confusion is that I do not think that needleless connectors should be used at all when there is continuous infusions. They are only needed when the infusion is intermittent. The last document from CDC on the revisions for this year stated that they would recognize the difference between continuous and intermittent tubing, saying that the change interval for intermittent sets is an uresolved issue. Lynn
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861